Oncology Medical News about chemo-induced nausea and vomiting control;omission of day2 antiemetic medication;cost saving strategy

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Omission of day 2 of antiemetic medications is a cost saving strategy for improving chemotherapy-induced nausea and vomiting control: results of a randomized phase III trial
American Journal of Clinical Oncology, 02/10/09

Lajolo PP et al. - In a study to confirm that delayed chemotherapy-induced nausea and vomiting control could be potentially improved by skipping the administration of a 5-hydroxytryptamine 3 (5-HT3) antagonist on day 2, it was found that complete delayed protection from nausea and vomiting (DCPNV) can be improved by skipping day 2 of 5-HT3-antagonists.

Methods

A trial was conducted in which pts received intravenously ondansetron 16 mg, dexamethasone 20 mg, and ranitidine 50 mg before highly/moderately emetogenic chemotherapy (day 1).
Starting on day 2, all pts received metoclopramide 10 mg per oral every 8 hrs (days 2, 3, and 4), dexamethasone 8 mg daily (days 2 and 3), and ranitidine 150 mg every 12 hrs (days 2 and 3).
Pts were randomized to receive either granisetron 0.5 mg per oral (days 2 and 3) (group A) or placebo instead of granisetron on day 2 and granisetron 0.5 mg on days 3 and 4 (group B).

Results

73 pts were enrolled.
Groups were similar regarding clinical characteristics, despite better control during the acute phase of chemotherapy-induced nausea and vomiting in group A.
DCPNV from day 2 to 5 was similar in both groups.
Analyzing DCPNV by logistic regression multivariate analyses, acute complete protection from nausea and vomiting and study group were independently associated with DCPNV.
Selecting pts who achieved acute complete protection from nausea and vomiting, it was observed that group B had a superior DCPNV (85% vs 50%).

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